Tuesday, September 24, 2013

To Achieve a Good Time, or to Have a Good Time?

Wow! Do I know how to pick an Ironman!  First, my previous Ironman’s were in St. George, Utah. The first two were felt to be quite difficult (the first had extremely cold water temperature and the second had an extremely hot run, in addition to a very difficult course) and the last one in 2012 has arguably been felt to be the most difficult Ironman of all time, with a DNF (Did Not Finish) rate over 30%.  When I signed up for Ironman Lake Tahoe I didn't quite realize what I was getting into. Yes, it was at a higher altitude than any ironman I had ever done. Yes, it had a lot of climbing. Finally, the possibility of inclement weather in September in Lake Tahoe was always in the background. I arrived in Lake Tahoe a week before the race in order to get acclimated to the altitude. This actually worked pretty well and my breathing was fine by race day. From the day I arrived, however, the weather report started calling for rain and cold weather the weekend of the race. I spent a fair amount of time obsessing over what I would wear on race day.  I have to say this turned out to be very useful with a couple of exceptions that I hadn’t anticipated. The day before the race there were some weather reports that were forecasting freezing temperatures on race day but when we woke up it looked like the temperature would “only” be in the low 30s. The day before the race one brings their gear bags to both transitions. It turned out we put our gear bags outside on the ground for the swim to bike transition and our run bags in a tent for the bike to run transition. While I had duct taped the top of my bike transition bag I still worried the night before the race that because it had been raining all day that it could get wet so when I arrived on race morning I checked the bag and my clothes at the top of the bag were dry. Despite all my planning and preparation I was somewhat scatterbrained on the morning of the race and ultimately forgot to do a few things like putting my red potatoes in my special-needs bag, or to calibrate my power meter on my bike, and a few other items. Because of the cold weather I decided to try to get to the race venue a little later than usual so I would not be spending as much time outside. In the end, I found myself rushing to get bodymarked, put my wetsuit on, get my bike calibrated, and put a cover over the opening to the stem on my disc wheel and get ready to get the beach in time for the start.  I arrived in the corral just a few minutes before the race was to start. In fact, I was still tightening up my wetsuit, pulling it up, getting it properly on with just a few minutes to spare when suddenly there was a tear in the crease of my right elbow about size of a quarter on my wetsuit. There was really nothing I could do about this except make sure I didn't make the tear bigger and monitor it during the swim. Fortunately, the water conditions were “good”. Because there was little wind there were no waves and the water temperature was about 63° out in the middle of the lake but probably in the 50’s in the shallow part as we waded in about 100 yards to the area of the lake where we would actually be able to start swimming. This wasn't too much of a problem at the beginning of the swim, but subsequently when getting out of the water would lead to increased issues as we exited in cold water, then walked up freaking cold sand and concrete to the changing tent. 

This race used a rolling start where the athletes seed themselves based on their expected time. I had previously swam about an hour and 10 minutes, with the exception of the 2012 St. George swim, but my swim has recently improved and I thought I could go a little faster so I seeded myself in the group that expected to go between one hour and an hour and 10 minutes. Let me start by saying this swim probably ended up being about four or five minutes slower than most swims, based on the times of the professional triathetes. Part of this may have been due to the cold temperatures but more likely was having to wade out approximately 100 yards before being able to swim both going in and coming out of the water. The first group started at 6:40 AM and I slowly walked to the starting line and then made my way fairly quickly into the water. I splashed cold water on my face which I knew with the cold temperatures would be important so as not to shock my system. I did my best to high step out as far as I could into the water and then when the water got above my knees to start swimming. I did keep a pretty good pace with the people around me and didn't feel like I was falling back or anything. I immediately headed towards the first swim buoy and I will say for this race I did a pretty good job of staying straight although I might've drifted a couple times. I realized that I was best to stay on the inside towards the buoys and because I breath to my right I can watch to make sure that I'm keeping the majority of the swimmers just to my right. The water was definitely cold right in the shallow parts of the lake but as we got going it was relatively comfortable. Obviously the first thing I paid attention to was the hole in the crease of my right elbow of my wetsuit. A couple of times I could feel water entering the wetsuit at the point of the tear, but quickly realized that really only occurred when I didn’t keep my elbow up during my swim stroke. Ironically, high elbows are a really important part of good swim form so I spent the rest of the swim focused on keeping my elbows high and really only felt water coming in a few times. I even thought to myself laughingly that perhaps I shouldn't repair this hole because it might be a good reminder to keep my form during a swim. I also thought about what this was portending for the rest of the day.  2013 had already had it’s share of challenges for me and my family.  Since I started with a group of people who should be swimming around my pace, it really wasn't difficult to swim along with the group and to find people to draft off. I got into a good rhythm and just got into my head that I was trying to swim comfortably, not too hard, and enjoy swimming in Lake Tahoe. Occasionally it got crowded and people pushed into me and I would push them away, especially around the turn buoy where I literally grabbed hold of some people to make my way around the buoy. About two thirds of the way through the first lap a woman punched me in the face. I don't think it was on purpose but who knows? It was the first time I've ever been hit by a woman while swimming in a triathlon. We made our way around the first loop and after I turned to start the second loop I looked at my watch and realized the first loop had taken me about 35 minutes, so I was pretty much on track with my swim. The second loop was fairly uneventful, in fact it cleared up a little bit for a while and I even went a short period of time without being able to draft off anyone. Then, I  found some people that were going about my pace and got behind them and tried to maintain a good comfortable effort and pace. When drafting I will at times touch the foot of the person in front of me and I had a number of swimmers that started kicking really hard to push me away. I don't do this, in fact when someone is drafting off me, I think it's okay for them to touch my feet and I wish other people would feel the same, but what the heck. As I came to the end of the swim I was feeling pretty good as I walked out of the water and started taking off my wetsuit I could feel the cold sand, as we were walking and literally as we made our way to grab our transition bag I began losing sensation in my feet. In fact by the time I grabbed my transition bag and moved over to the wetsuit strippers I literally couldn't feel my feet. They literally felt like two blocks of ice. On a sidenote I'm sure the people who swam for a longer period of time, or those who used short-sleeved wetsuits, were destined to get hypothermic during the swim and absolutely it didn't take long with 34° temperatures after leaving the water to have your body temperature go down pretty quickly.

Entering the changing tent was an experience to say the least. I saw one description on Facebook that describe the situation in the changing tent as a cluster fuck. The bottom line is despite the fact that my swim was in the top 25th percentile of all the athletes (one hour and eleven minutes) the changing tent was already completely packed with athletes. It was a completely disorganized mob scene with people roaming around trying to find a place to change, some were changing at chairs, others just changing right there in the middle of the tent and literally you could actually have trouble finding an empty space of any sort.  Furthermore, it was dark and you could hardly see.  I made my way to the far end of the tent and found a seat that was empty and put my gear bag on it and opened it up. I opened it up and started getting into my race gear. I realized that the first thing I needed to do was get dry and clean my feet so I moved my bag to the front of the seat, sat down, grabbed a towel and started drying myself off. I stood up and put on my racing pants and then my racing top, which I needed a little help from the volunteer to put on, and then put on my arm warmers which also needed some help. They'd been much easier to put on when I was practicing in my hotel room where it was nice and warm and dry but in the cold and damp conditions it was a bit tougher to put on the arm warmers. I then put on my new Jabba winter cycling jersey and then put on a second set of arm warmers. Finally I put on a lightweight short sleeve windbreaker and sat down in my chair and I went to take care of putting on my bike shoes. Once again, I went to dry my feet off and then went to take the socks out of my bike shoes and to my dismay found that my socks were wet! Lesson number one for the future if there's any chance of inclement weather, put your socks in a Ziploc bag so this does not happen. I did have shoe covers on my bike shoes and so I had to make a quick decision whether or not to put on wet socks in freezing cold temperatures or to go without socks. I thought briefly about this and made a quick decision to go sockless and deal with the consequences. I at least figured the shoe covers would protect my feet from the wind and sooner or later my feet would warm up. On the course they didn’t warm up till about halfway through the bike. I finished putting both my shoes on and zipping up the shoe covers. Of note probably because of the way I put the shoe covers on they were never fully zipped, and during the whole ride I intermittently would have to reach down and rezip them up or they were just sort of partially open and dangling, not the most aerodynamic set up. Next I went to get my gloves and again to my dismay my gloves were soaked. This was a really tough decision.  Do I put on wet gloves, which first of all would've been hard to put on and then go out and have my gloves freeze to my hands or do I go without gloves? Once again I made a quick decision to go without gloves. I knew my hands would hurt but sooner or later they would probably warm-up. This is an interesting calculation because we didn't really know what the high temperature for the day would be and in fact I'm not sure it ever got out of the mid 50’s and there was more cloud cover then I would've expected based on the weather report. Yes, I almost forgot to mention that while sitting on my chair someone stepped on my toes. Of course I couldn't feel it because my toes were numb.  Finally, I got up and I made my way ever so slowly out of the changing tent, through the mass of dazed athletes, and walk/ran in my bike shoes all the way around the bike transition to the far end where my bike was. I really did not like the layout of this bike transition.  The way it was set up made for an interminably long transition.  First, the changing tents were difficult to navigate and secondly you had to run all the way around all the bikes to get your bike and then run back through the entire bike set up to get out of the transition. I would much prefer the St. George set up where we literally came out of the swim into the changing tent and out of the changing tent straight through all the bikes and even had volunteers helping us grab our bikes and getting them to us as we ran out of the of the bike transition to start on the bike course. So in the end my transition from the swim to the bike took 18 minutes. I'm not sure that this was that much longer than a lot of people’s transition time and certainly shorter then some. For those who were slower swimmers this certainly would've presented a problem in making the swim time cut off.     

 I mounted my bike and made a sweeping right turn coming out of the transition, and there was Rudy holding a pair of gloves but I just saw him at the last second and couldn't really stop. In retrospect I should have. I made my way down the main road in Lake Tahoe and quickly got up to speed going around 20 miles an hour.  My legs felt good and my power readings were about where they should be and my fingers were cold. I blew on them every 30 seconds or so which probably wasn't the most aerodynamic thing to do. I started taking sips of my electrolyte drink and there was a short little turn off and a little hill that they had put on the course that we went up three times throughout the course of the day. It seemed like on this course despite the fact that there were two major climbs that they decided to put in a bunch of other short little climbs just to make things all the more difficult. Next was Dollar Hill which was basically about a 7/10 of a mile climb which the first time up it really wasn't too bad. I took my time and hoped that I would be warming up but I looked up the sky and it was cloudy. Originally I thought that there'd be sun out on the course and despite the mid 30s it could warm things up but nope that was not to be the case. Typical to my way of thinking I realized that I didn't have gloves and I wasn't going to have gloves and my fingers were going to be cold so I better figure out how to deal with. Ironically, my fingers began to hurt so I never really paid too much attention to the fact that my toes were frozen as well. I had the red potatoes in a little bag on top of my top tube and it was “fun” picking those up with frozen fingers but I did manage to get my nutrition for the day. This is actually very important as it all three previous Ironman St. George’s I had stomach problems on the bike with cramping that generally continued throughout my run. I have recently been playing with the red potatoes with a little olive oil and salt on them and this seems to both provide good nutrition as well as keep my stomach under control. I also had some gels that were made primarily of honey which I can tolerate but they were in my Gabba jersey which was covered by my windbreaker which is why every time I reached to get the gels out of my jersey I couldn't. It's kind of funny what you think and don't think about during the race because it took me about halfway through the race to realize that my windbreaker was covering the back of my jersey! So instead of those gels I just grabbed a couple gels from the aid station as I went by. In the week leading up to the race I had ridden on this road a couple times and there generally was a tailwind. Today there was a headwind. Nevertheless I kept a fairly good pace on this part of the route, although it would've probably been a little easier to go a little harder if I wasn't in pain from my fingers. As I rode, I recalled that the one special needs bag station was right off theisroad and I began hoping that it was within sight of the bike course and I thought maybe I can go get my gloves which I thought I had put in the special-needs bag. Interestingly my gloves were in my run transition bag so that wouldn't have mattered and fortunately the special-needs stop was not within sight of the bike course. As I worked my way into the town of Truckee I knew that Rudy had planned to be there seeing me as I made my turn from Truckee at the 25 mile mark. I began to hope that perhaps Rudy would've thought to bring my gloves to that spot and fortunately he did. While one is not supposed to receive assistance from anyone outside the course, I figured that it was more important for my health and well-being that I get gloves on. I pulled over and couldn't even put the gloves on myself. Rudy put them on my hands and I took off once again. Shortly after I started shivering and realized that I had been on the verge of hypothermia. I hoped and was correct that after a while my hands warmed up with gloves which by the way weren't the most aerodynamic gloves, but they certainly were warm. Shortly after the town of Truckee we had a turn off to yet another climb and a bikepath where there was a brief respite because of a no passing zone. I always like these because it was a short break and less pressure not worrying that someone is going to pass you during this time and so there's no pressure to speed up or go faster. Coming out of the short climb we turned onto the road and made our way again after a series of other short climbs and then down towards Martis Camp. Apparently, the people who live in this area didn't want cyclists riding through it preparing for the race, so there was no way of checking out this part of the course prior to race day. Now that I've rode through it I have no idea what they were concerned about because we really weren’t riding through neighborhoods or near houses or anything like that. 

 The more problematic aspect of the climb through Martis camp was the fact that you have short relatively steep climbs and then descents, but at the bottom of the descent would be sharp right turns leading to the next climb so you couldn't carry the speed into them. I had originally thought that climbing Martis Camp was just a basic 3 mile climb but it turned out to be a series of smaller climbs after smaller climbs. Finally, coming down from the top of Martis Camp we had a relatively technical descent that didn't allow us to really get our speed going too much. As we finished that, we then had the major climb up to the top of Brockway Summit. That was an approximately 3 mile climb that got steeper as you reached the final part of the climb, probably close to 10%. Turns out the pros were going about 8 to 9 mph on this climb and my speed up the climb was about five and half miles per hour the first time. We'll talk about the second time later on. As I climbed I was passed by a ton of people. I still think the most likely reason is that people tend to put out more power going up climbs and I choose to maintain my power but also on the flats keep my power at the same level whereas others probably don't do that. Considering that I typically tend to catch the people who passed me on the climbs I don't have any plan in the future to change that strategy. Coming down the other side of Brockway was a very fast screaming descent, where I hit 43 miles an hour while generally staying out of my aero bars but occasionally went into them for a brief period of time. As we came to the bottom I finished the first loop of the bike course. I have to acknowledge that I never looked at my watch to see how long it was taking and interestingly it didn't seem like it'd taken that long. This is probably a testament to my continued attempts and approach to stay in the moment and enjoy the race. I think that on my way again through Tahoe city and back onto the second loop of the bike course I was actually feeling fairly good.

Part of the way into the second loop I was passed by a woman named Betsy that I had met a couple night’s before. She’s an excellent cyclist and I had actually expected her to catch me earlier than this so that felt pretty good. I then passed Betsy and was staying behind another cyclist by the requisite 7 m so that I was not subject to any drafting penalty. I was very careful having received a drafting penalty in one of my last races, not to put myself in that position again during this race. After drafting legally for a period of time I passed him and then realized it was my friend Toby who then passed me back.  We continued this for a while until we got to Truckee and Toby pushed ahead which didn't surprise me. I had been surprised to see Toby at this point of the race figuring that he always swims faster and bikes faster than me. It turns out that despite a fairly solid swim he ended up spending 35 minutes in the first transition, needing the warming tent to get warmed up because he probably was hypothermic. I think it's important to make a comment about hypothermia. I remember from the 2010 St. George race that many people got hypothermic during the swim. The amount of energy and calories burned that hypothermia takes on the body is certainly a huge factor in a race as long as ironman. I know that it affected Toby's race and in retrospect I'm sure that if I had been able to keep warm coming out of the swim onto the bike by keeping my hands and feet warm I certainly couldn't have save a little more energy to expend during the Bike or to preserve for the run. The other notable factory is that if you're burning more calories it's not so simple to take in more calories during the race because there's only so much that your body can handle at any time. I think in the future that Ironman Lake Tahoe is going to have to give a lot of consideration to this because a 30° temperature situation for an Ironman has a profound effect. I can only wonder what would've happened if this race was held a day earlier when it was cold and raining. I think they would've had to call off the race under those circumstances. 
During my training I had been holding and trying to maintain about 170 watts of power during my bike rides and during this race my wattage was closer to 160 W. I think between the cold weather and the altitude that this probably was not too bad. As I headed to Martis Camp the second time it wasn't much more difficult but I was noticing the hills a little more and began wondering how the Brockway climb would feel. Of note, I had noticed some cramping in my left quad a few times earlier in the race when I pushed a little harder on my pedals but I'd been careful and this did not return. As I headed up the Brockway climb the second time, it was a bit of a grind and about two thirds of the way up I stood up on my pdtals for a brief moment and my left quad just seized up. I immediately thought about what I needed to do and realized that if I continued to try to push up the climb I would risk some greater problem with that quad that might affect the rest of my ride and even more during the run. I did a quick calculation and figured that I was about a mile from the summit.  I got off my bike and walked the mile. I figured that by doing so I would probably lose about 10 minutes and in fact that's exactly what I lost timewise. As I got to the top of the climb I stopped and got some energy drink and as I was pouring energy drink I finally was able to pee.  Granted, right there standing next to my bike, in  bike shorts and down my leg. But, I was able to get some water to rinse off my leg. I for one have always had trouble being able to pee while riding my bike. This is a skill that perhaps I need to practice. Somehow, I'm not sure if I really can learn this skill as it may be more of a physiological issue. 

It was nice getting on the bike going down the Brockway descent again, giving my legs a chance to recover and rest before the final turn to go towards the finish which would be about 22 miles. The weather forecast had been correct and the headwinds on the way back had started to pick up making the ride to the finish a little more challenging. I kept my effort reasonably solid but again didn't want to push too hard in order not to exacerbate any issues with my legs. I finally rolled into the transition and got off my bike.  My bike time was approximately seven hours and 15 minutes which placed me about 800 overall off the bike. Since over 2200 people started the race, that wasn’t too bad. This had been one tough bike course, and only two of the male professionals rode the bike course in under five hours and the average time for the female professionals was over six hours. I got my bag from the transition, sat down and methodically went through changing into my bike shoes, putting some salve on both of my quads and getting prepared for the run. 

It was time to decide what was going to happen next.  It's kind of funny because later on as I was talking to another couple of athletes one said he did ironman for the healthy lifestyle and the other said he did it for the challenge.  I realized that I do Ironman for both the lifestyle and the challenge which meant if there wasn't a specific challenge (from a time perspective) to be had then this was an opportunity to enjoy the rest of the day.

This was really a key moment in the race. I could have been disappointed in the day and my time and been negative but instead I chose to look at why I do ironman and what feeling I wanted to have the rest of the day. If I do Ironman for the lifestyle and for the camaraderie and for the experience then I needed to approach the rest of the day for all those reasons. If I couldn’t achieve a good time, then I could have a good time!  And so with that decision I began the rest of my race. I walked when I could and I ran when I felt like it and I talked to people as much as possible. I met Lou, a very nice gentleman in my age group who as it turns out in 2011 finished Ironman St. George within one minute of my time. We talked about our families, we talked about triathlon and it turned out that he trains with a team not that far from where I live. I ran into Liz Barlow or rather she ran into me. She turned and said, are you Mike Wasserman? I said yes, it turns out that I know her father, we used to go to the same health club in Denver and I had run into him a few days earlier and to some friends of theirs a couple days later. It's kind of funny how things like that happen in the midst of the day like ironman. As the evening went on I ended up walking and running with Ross and Denny and as we got a couple miles from the end I ran ahead to use the port a potty but realized I still had some running legs under me. I had wanted to run on the way to the finish and make sure that I ran through the village to the finish line. 

On a positive athletic note, when I did run my form was good, but there was just only so much running that I could do. Furthermore, I might've been able to run a little bit more and shave off a few minutes from my nearly 14 1/2 hour journey but I wouldn't trade that for the people I met and for the experience I had. One of my favorite television mini-series is Band of Brothers and that's what we all were on this day. We were all in this together.  The experience itself was what made the day so epic and in the end I wouldn’t have done it any other way, except for having dry gloves and socks on the bike.

In the spirit of being challenged I have Ironman New Zealand and Ironman Boulder next year and I look forward to seeing what I can do on flatter courses with one at low altitude and the other, Boulder, at high altitude. As many have commented on Facebook, beware of any race that I choose to sign up for.  My daughter suggested that Ironman New Zealand might be accompanied by an erupting volcano with hot lava running through the course!  Who knows what will happen in Boulder?

With that said, however, every Ironman stands on its own. The experiences one has doing an ironman will also stand on their own. I know that many of the 25% that did not finish yesterday are disappointed, but it really isn't about finishing. It is about the journey to get there and the work we put in that really matters. To this day one of my proudest accomplishment is my only DNF, which occurred in the 2009 Long course world championships in Perth, Australia. I had a bike crash shortly after starting the bike ride and managed to ride my bike 48 miles and walk 3 miles before going to the hospital with a fractured collarbone and hip socket. Instead of being disappointed I was proud that I pushed on as far as I could, although my wife thought I was insane!

My run/walk turned out to be my slowest ironman marathon ever, at 5 hours and 30 minutes.  I finished 71st in my age group, out of 159 that started the race.  Thirty five of them didn't finish.  I finished 936th overall, out of over 2200 who started the race.  Over 25 percent of them didn't finish.

As I ran through Squaw Village and the people lined up against the barriers were cheering me on, I made sure to high-five with any kids, smile, and to raise my arms in celebration. I managed to do the highest jump I could imagine doing as I crossed the finish.  I was an Ironman again.

Saturday, September 21, 2013


It's cold, windy and raining today here in Lake Tahoe.  Fortunately the race is tomorrow.  The weather report this week has been pretty consistent, so I'm counting on there not being a repeat of St. George, where the weather changed drastically at the last minute.  That said, I'm pretty much ready for anything tomorrow anyway and that's what Ironman is really all about.  If I've experienced something in the last few years on a regular basis it's the fact that life throws curve balls at you on an almost daily basis.  Maybe I need to learn something from my ironman training and figure out how to better prepare myself to react to life's curveballs?  It's a problem I've seemed to have for a number of years.  It probably started due to my work-a-holic tendencies.  I'd be working day and night and not getting my brain prepared for the other issues in life.  Heck, my wife took care of all of them!  Maybe meditation is a good idea.  In some ways, that's what my training is.  It's my way of reaching a state of equanimity. 

Tomorrow will be all about equanimity.  The water will be quite cold for the first hundred yards, but then it warms up to a reasonable level.  So, wading into the cold water, I'll be reminding myself that it will warm up.  Once I start swimming I'll be dealing with other swimmers, there's always the possibility of getting hit or swum over...stay calm, relax and just keep swimming.  One of my strengths is that I do my best swimming when I'm relaxed and just maintaining good form, there's no point for me to try to swim hard.  Getting out of the water will find cold temperatures.  Fortunately, there's no rain in the forecast...but you know what, if it rains, I'll have to deal with it.  I am prepared to get dry and warm before starting the bike.  A hundred and twelve miles on a bike, for over six hours, is definitely a long slog to most.  To me, it's why I do Ironman.  I'm planning to enjoy the whole bike ride.  If anything happens like it did at St. George, I'll deal with it and move on.  Finally, the run will be my last chance for the day to deal with unexpected situations.  The only real unexpected things that happen during a run are physical.  The only way to deal with those issues is through one's mind.  Hey, in 2009, I rode my bike 48 miles and walked 3 miles with a broken collarbone and fractured hip socket.  What can't I do?

A year and a half ago, my coach told me to "stay in the moment" throughout the day.  For the rest of my life, I'll remember that moment in the water when I was surrounded by 5 foot swells, had swallowed water, and had a calf cramp.  I got into the moment, found that feeling of equanimity, and just started moving forward.  That's a moment I can always go back to during a race and during life.  I just need to remember to do so, tomorrow, and forever after.

Friday, September 20, 2013


I never got to blog yesterday because I have having such a good day with my friend Rudy.  Two more days before Ironman Lake Tahoe and Rudy noticed today how relaxed I am.  It helps to have done this three time before.  It helps to have been preparing for the last year.  It helps to have a friend along to absorb some of my neurotic tendencies.  I spoke to my coach today, and he reminded me to just enjoy the day on Sunday.  Ironically, I'd already figured that out.  Yesterday, I met someone on the elevator who said, "I can't wait to get off the bike and start the run".  This really struck me.  Why do an ironman if all you want to do is get off the bike and get on the run?  Granted, there may be moments during the bike ride, especially after around 80 miles, where this type of thought may cross ones mind.  But, certainly, I don't think this is something to be thinking about before the race even starts.  Well, to each their own.  Everyone has their own reason for doing an ironman.  It's just that comments like this that make me very comfortable with my reasons.

I'm looking forward to Sunday.  I'm looking forward to enjoying every second of the day.  I can't wait to cross the timing mat and going into the water (the starting cannon won't have the same meaning in this race as everyone won't be starting at the same time).  I can't wait to just enjoy the beautiful clear waters of Lake Tahoe for 2.4 miles.  I always find the transitions to be challenging and exciting in their own way...it's part of the sport and something I plan (obsessively and excessively some would rightfully say) for.  I can't wait to ride my bike through the Lake Tahoe area.  The scenery is gorgeous.  I've taken great pains to make sure that I don't get too cold on the bike...that wouldn't be fun!  I will remember to smile throughout the day.  If I have tough moments, smiling can change negative body language.  There will be fast descents, there will be beautiful climbs.  I will enjoy handing my bike off to a volunteer at the second transition.  Getting off the bike after 112 miles is always a unique experience.  I will be loving the feeling of changing into my running shoes.  Finally, I get to run through some more beautiful country.  I will keep smiling.  I will keep reminding myself of my passion for triathlon and for life.  I will remember that I've really tried to live my life, as Chrissie Wellington put it so well, "without limits".  I will feel no limits on Sunday and I will keep smiling, even as I get to the last 10 miles of the run.  My body might try to rebel, but my mind will smile:)

Wednesday, September 18, 2013

The Arrogance of Power and The Power of Arrogance

About fifteen years ago, when I was President of GeriMed of America, a Geriatric Medical Management Company, we were having discussions with Oxford Health about working together.  We believed in a model of care that fully embraced Geriatric Medical principles and Care Coordination.  We had data to suggest that it was cost-effective.  Quality data was harder to put one's finger on at that point in time (and still is to a large degree for many complex reasons).  Oxford Health was boasting about their extensive use of Disease Management programs.  They had programs for congestive heart failure, diabetes, heart disease, etc.  Each of these programs had demonstrated cost savings in the millions of dollars.  Oxford Health was the darling of Wall Street.  I was skeptical.  How could multiple disease management programs work in the elderly population.  Many of our patients had all of these diseases.  They couldn't be on all of the programs.  What they needed was a comprehensive approach to care that was based on Geriatric Medical principles and Care Coordination.  But, Oxford Health was a big company and they were the darlings of Wall Street.  They must have been correct?  They believed they were.  Shortly thereafter, Oxford Health reported huge losses and their stock dropped precipitously.

About a year later, we were in discussions with Humana about developing a Geriatric Management program.  We went to Louisville, Kentucky, to meet at Humana's corporate headquarters.  Humana was also proud of their Disease Management programs.  Part way through the meeting, I told them what I thought of Disease Management programs in the elderly.  I thought they looked and sounded good, but that they didn't work.  What they needed was a Geriatric Management program.  The Vice-President we were meeting with suddenly stood up and left the room.  Business opportunity lost.  My VP of  Business Development was quite upset with me. 

I've been watching The West Wing this week as I rest in preparation for Ironman Lake Tahoe.  It's interesting how I don't remember seeing President Bartlett as a supremely arrogant individual whose arrogance clouded his ability to make the right decisions.  I suppose that it helps to be arrogant if you want to become President, but that arrogance has two sides to it.  I used to have an interest in politics.  I still want to improve our health care system in order to effectively and appropriately care for the rapidly growing population of seniors in our country.  Since Medicare is a Federally legislated program, change must wind itself through the political process.  I've gone to congressmen and senators full of information and some degree of arrogance myself.  I've gone to them passively and offered to share knowledge and help them to come to solutions.  Arrogance sometimes requires arrogance in order to communicate.  Other times, it's like a head on collision.  Passivity rarely works, unless you can find a way to couch your message in a way that others can't avoid thinking about it. 

I've had plenty of times in my life when I've been full of myself.  Honestly, at least I can usually back it up with facts and experience.  Still, if I come across as too arrogant, it will turn people off.  On the other hand, not touting accomplishments that support my message will not get me anywhere either.  Our government is chock full of arrogant people, similar to those on The West Wing.  In that regard, the show had it right.  I understand that every day they encounter people who come in and tell them that they have all the answers.  Yet, our government representatives have chosen that life and chosen public service.  Public service should not be about bolstering one's arrogance.  Public service must be about listening to all sides, trying to find consensus, and keeping an open mind. 

I'm not sure what my next step in life is.  I'm a Geriatrician who was successful enough co-founding and building a primary care practice that cared solely for Medicare beneficiaries that I was able to retire at the age of 53.  A practice that no one thought possible in a health care system that is clearly broken.  I've run health care businesses that have been profitable and cost-effective while serving the very population that is costing our government so much money.  I met with Senator Wayne Allard on a few occasions.  It took me 2 1/2 years to meet with Senator Michael Bennet of Colorado.  Finally, when I met with him he told me how he welcomed my ideas and input.  I sent him my ideas.  Never heard back.  Business executives know about the concept of benchmarking.  If you find a successful program, don't try to reinvent it.  Learn from it.  On the other hand, executive in large companies are often trying to protect their own turf.  It's their job that matters, not necessarily results.  Unfortunately, in the health care world, so long as there are profits, no one seems to care about the cost to society or the quality of the care.

What's the message here?  Large health insurance companies believe their own hype and people want to maintain their jobs and power base that they will not welcome solutions from the outside.  Our government seems to run the same way.  Republican, Democrat, it doesn't matter.  I've shared my thoughts with congressmen, senators, and their staffs.  I was part of a company that built the largest primary care geriatric medical practice in the country.  We were successful.  I think that if I am to ever make any headway, I must keep sharing my successes, even if some find it arrogant.  I am always open to a vigorous discussion and debate.  I learn every day that I don't know everything.  There is always something to learn.  On the other hand, does anyone believe that the present health care system is working effectively? 

Tuesday, September 17, 2013

Passion and Patience

I wasn't sure what to write about today, but it finally came to me.  As I get through this final week before Ironman Lake Tahoe, the urge to go out and exercise certainly exists.  All of the books on preparing for a race caution not to waste ones energy in the days leading up to the race.  Save it for race day.  I'm typically not someone who likes to wait.  I've always been the one raising their hand to make sure I get my point of view made.  When I believe in something, I want to shout it from the rooftops.  When I train for an ironman, I want to get out there and train.  On Sunday, the key to a successful race will be patience.  I don't want to have any needless wasting of energy.  That's why I'll focus on staying warm in the morning and why I'll take a little extra time in the first transition to get into warm and dry clothing.  I may lose one minute doing this, but I could lose an hour later in the day if I waste too much energy early on.  Yet another good life metaphor. 

I've been dealing with Kaiser recently in regards to my 88 year old father-in-law.  Today, there was an issue.  He has an appointment tomorrow with the geriatric clinic that hopefully will get him better and more coordinated care than he has been receiving.  They called to cancel his appointment today due to some protocol that they have.  Knowing that every minute that went by could lead to that appointment slot being filled, I had no patience.  I called and left messages with every possible person who might be able to rectify the situation.  Finally, I got in touch with someone and resolved the problem.  Throughout the last year I believe that my patience has not helped my father-in-law.  I have let the system take care of him and that was a mistake. 

One of the things I am most passionate about is the care of the elderly in our society.  As an active member of the American Geriatric Society I have often worn my passion on my sleeve.  I believe that the AMA doesn't have the elderly as one of their highest priorities and that specialists making a lot of money for doing things that have not been shown to benefit the elderly is a greater priority.  There are times that my passionate oratory about this topic might turn some people off.  On the other hand, sitting back and being patient...I really don't know.  It's kind of interesting in terms of yesterday's discussion of strengths and weaknesses.  Knowing when to use passion and when to use patience is the ultimate art form.  I hope that I am learning how to do that. 

So, back to Ironman Lake Tahoe talk.  On Sunday, when I start swimming, I must remember to be very patient.  Slow and steady wins the race, as they say.  Or, rather, fast and steady when it comes to swimming.  Swimming is generally about form, so I can think fast while still swimming as easily as I can.  The bike is 112 miles.  The first 80 miles of the bike are not where I want to expend all of my energy.  I've done that before.  The first 80 miles of the bike will be all about patience, about not pushing too hard, about enjoying the day, about being comfortable and relaxed.  Finally, comes the run.  I've recently learned that running can be like swimming.  Going easy does not have to mean going slowly.  Since I've got that idea in my head, my running pace has improved, even when I'm not pushing too hard.  The first 16 miles of the run will be all about being comfortable, relaxed, smiling, and going as fast as I can with those feelings in mind.  After that, and only after that, when I get to the second loop of the run, can I let go and allow my passion for ironman to fully come through.  Only at that point can I let loose and see what my body can do.  I've been looking for the message my friend Rudy can deliver to me as I begin the second loop and I just found it.  Passion.  Being patient all day will allow me to be passionate at the end.  Kind of like life...

Monday, September 16, 2013

Strengths and Weaknesses

My wife recently shared a very interesting article with me and today it really hit home for me.  It was about how ones strength can also be ones weakness, and visa versa.  As I'm preparing for my Ironman (yes, right now that is what seems to inspire my life's musings), my obsessive-compulsive side definitely comes out.  This morning, I did a test run in my race day clothes, while the temperature was about 39 degrees.  Unfortunately, weather prediction is an inexact science, and I won't have a decent idea as to the weather on race day until the day before the race (not that that helped in St. George in 2012).  The thing is, at a certain temperature, the amount of energy that I will lose fighting the cold becomes a very important factor in the success of my day.  So, I wore my tri top and my Gabba cold weather jersey, with my Castelli nano arm warmers, put shoe covers on my shoes and wore my Zoot compression socks.  I had my KASK aero helmet with the visor on in front and Pearl Izumi headband (that seems to work in both hot and cold weather).  I also had a pair of Castelli Rosso Corso gloves on.  After riding for one hour in 39 degree cold, my head felt fine, my legs were ok, my body seemed fine, though, finally started feeling a little chilled.  But, just 15 minutes into the ride, my fingers were frozen and uncomfortable, ultimately becoming numb and somewhat painful at the end.  My toes were ok for most of the ride, but also started feeling a little numb right at the end of the ride.  The good news is that my OCD got me to test out my gear well before race day.  It then went into overdrive, as I found that a magnet on my visor had fallen off and so I was risking having the visor fall off if I hit a bump.  So, first thing I did back at the hotel was to go online and order a new visor, having it two-day shipped to me.  It so happened that the site I was on also had cold weather gloves and socks, so I took my best guess and ordered them as well.  A hot shower and getting under the covers got me warmed up after a couple of hours, but I was reminded yet again of the impact of lack of preparedness for cold weather in the first couple hours of a twelve hour day.  I'll be better off being too warm, than being too cold.  Plus, I can always shed gear.  If I didn't care about my time on Sunday, and I do, I would bundle up completely and not worry about having it slow me down.  Instead, I'll try to find the "perfect" combination of warm clothing and gear to coincide with my desire to maintain good aerodynamics. 

This same obsessive-compulsive behavior helps me have very good transition times during a triathlon.  I visualize the transitions many times prior to race day.  OK, enough about triathlon, although my daughters have probably stopped reading the blog by now.  I'm one of those people that tends to overthink things.  Or, at least that what it seems like at times.  My wife knows that if we have a plan for something, I somehow manage to come up with three or four alternative plans, just because one of those might be better.  Often, they're not, but occasionally they are.  My business partners also probably will have gone a little crazy over the years with my need to look at all the possibilities and to think of solutions to all of them.  When I'm going to have a meeting, I think about it over and over again.  Ironically, I hate role playing out loud, but I do it in my head all of the time. 

So, is this a strength or a weakness?  I'll let others judge that for themselves, but clearly I've got to where I am today by being who I am.  The compulsion to think of all the options has allowed me to rarely be surprised by a turn of events.  I will often come up with solutions to unforeseen problems and be prepared for them.  On the other hand, I'll stress over unforeseen problems that never occur.  It's easy to sit from my present vantage point, note that in many ways I have been quite "successful", and state that this behavior is a strength.  On the other hand, it probably adds stress to my life, which as I've learned from my triathlon training, affects the body in many ways that we are often unaware of. 

Ten years ago, after a  hiatus of several years from triathlon, I reengaged in the sport.  Over the past ten years I have managed to continue to improve, and even now I expect to achieve a personal best this coming week in Lake Tahoe.  Again, is this a strength or a weakness?  If I avoid hypothermia on Sunday and conserve my energy for the run, it will have been a strength.  If I lose too much sleep over it, then maybe not. 

Human beings are complex.  Some traits can be strengths on one day and weaknesses on another.  Perhaps it's growing and learning when to use those traits appropriately that is the real goal.  I've often said that I learn every day how little I know.  If I can maintain that attitude, never assume that I have all the answers, and keep trying to learn, then my journey will continue to be productive.

Sunday, September 15, 2013

How Does Time Fly?

Today I drove eight hours from Los Angeles to Lake Tahoe.  The time flew by in no time.  In a way, I expect the same thing to happen in one week.  Twelve hours, or less I hope, can go by quickly if one's mind is in the right place.  It's a remarkable sensation that I have recently been reminded of during my trail runs.  A three hour trail run barely felt like one hour.  Today's drive was not very different.  I occupied my time by doing a few things.  One of those things was visualizing the race.  I visualized the swim, getting into the water and not working hard...visualized the transition from the swim to the bike ride (I hate wasting/losing time in transitions)...visualized portions of the bike ride...visualized the transition from the bike to the run...and finally, visualized the run.  I also listened to some football games (the Bronco's had a good game today), some golf (yes, I actually listened to golf on the radio), and finally, listened to my favorite music (60's and 70's).  I also spoke to my dad, my wife and a friend (Bluetooth, of course).  The time flew by. 

They say that doing an ironman is 50% physical and 90% mental.  The reality is that one must be physically prepared to complete an ironman, but that is just the starting point, the baseline.  Once you're physically prepared, you've only just begun.  The real work is the mental part.  After three ironman's, and many hours of training over the last 3 1/2 years, I hope that I've trained my mind for next week.  I have encountered all levels of adversity during my previous three ironman's, and have realized that ironman is about patience.  One cannot overextend during the swim and bike, not to mention the transitions, as well as during the first 16 miles of the run.  The "race" truly begins around 16-18 miles.  That's my goal, to get to that point while maintaining the physical ability to utilize all of the mental training I've done.  Once again, ironman imitates life.  We learn the things that are important to us.  We gain the tools to do the work we have to do.  Every day is an experience.  Sometimes we think we know something, but later learn that there is still more to learn.  Life requires patience.  Life requires mental fortitude.

When we're young, it seems like time goes by ever so slowly.  There is so much to learn...so much we don't know.  As we get older, time starts going by faster.  I'm not sure why, perhaps it is because we've learned a lot, and what we now learn is supported by all of the information we have in our heads.  I don't know.  Training for an ironman is similar, though, as we build upon our training.  I remember during my first ironman, wondering how I could ever complete a marathon, knowing that I was going to have to walk half of the time.  But I did.  When I reached the run of my second ironman, I knew that I would finish, it wasn't a question.  The experience helped me.

We encounter challenges in our lives every day, every week, every month.  We wonder why?  We wonder what we can still learn.  We wonder what we've done to deserve the challenges we face.  In fact, it's not about deserving the challenges, it's about accepting them as such.  Life is a challenge, ironman is a challenge.  We persevere, we learn, we move forward.  Sometimes we don't want time to fly by.  We savor the moment, but now I'm back to the issue of the moment.  While it's about being "in the moment", life is really about a series of moments.  No single moment defines us, nor do we judge the quality or "success" of our life by any one moment. 

I will continue to visualize throughout the week, and hope that visualization becomes reality in one week.

Saturday, September 14, 2013

It's All Relative

Tapering for an ironman is an interesting experience.  This morning was a super, super easy workout, just a 30 minute bike ride and a 10 minute swim.  It felt like I'd hardly worked out.  Then I realized, a 40 minute workout, that's all I would recommend to any of my patients.  In fact, studies have shown that the ideal amount of exercise is probably about 30 minutes a day, five to six days a week.  If everyone did that, we'd have a much healthier society.

I guess this leads me into two separate discussions.  The first is whether ironman training is overkill from a health perspective.  On this the data is not clear.  I recently read an article that Tour de France riders actually live longer than the average person.  When I see 80 year olds completing an ironman, I have to believe that exercising a lot is not harmful.  Ironically, the most dangerous type of training is high intensity, potentially leading to an increased risk of injury as well as the production of free-radicals, which has some theoretical risk.  Ironman training tends to be lower intensity, with a focus on endurance.  Next year will be interesting, as I have an ironman in March and August, making a total of three in one year.  We'll see how my body reacts to this, and I'll keep thinking about my perspective.

The other discussion is the general idea of daily regular aerobic exercise.  There is plenty of data showing the benefit of this.  In fact, I've told my patient's for years that if they exercise regularly we can probably reduce at least one of their medications.  That said, weight training is also helpful, especially as we get older.  There was a study done over 20 years ago that showed that bed bound and wheelchair bound elderly in a nursing home could walk again with an intensive weight training program.  We're presently testing this theory with my 88 year old father-in-law.

Tomorrow, I leave for Lake Tahoe.  I will keep blogging on whatever topics come to mind during my taper week.

Friday, September 13, 2013

Rest and Recovery: From Training and Life

If training continues to teach me one thing, it's the importance of rest and recovery.  Today I did a 1 hour bike ride, followed by a 45 minute run...my last solid workout prior to Ironman Lake Tahoe.  I was feeling a little under the weather when I got up, probably because I was fighting the same stomach bug that my wife and daughter have.  Fortunately, I generally have an approach to stomach bugs...keep my stomach empty!  So, I had a couple of pieces of toast before my workout and water during it.  I've been trying to eat responsibly the rest of the day.  I couldn't start resting, however, until I went and took my father-in-law's hearing aid in for possible repair.  Turns out the batch of batteries he has are bad...just needed a new battery!  Kind of a metaphor for him right now:).  Ironically, he's ready for a rest and recovery afternoon.  As he recovers from his recent illness, walking a couple hundred feet is his marathon.  He did it three times this morning, despite a bad night's sleep.  So, I encouraged him to rest for the remainder of the day...that's what I did after stopping at the supermarket.

The body gets stronger when it is resting and recovering from training.  The training generally breaks things down...the recovery builds it up.  In a lot of ways our minds are like that as well.  This year has had it's fair share of mental stressors, training for an ironman is arguably part of that, although I often feel it's an opportunity for me to rest my mind...except during a hard workout, when one needs to mentally push through the pain!  With 9 days left before Ironman Lake Tahoe, there's really no more training that will help me be faster or stronger.  Getting the appropriate amount of rest and recovery, while staying loose, is what's important.

The mind needs resting and recovery as well.  I've been thinking about forgoing the internet over the next several days, particularly Facebook.  It's a tough decision.  I actually keep up with a lot of people of Facebook and generally don't see it as stressful.  That said, I have to admit that I check Facebook regularly throughout the day.  When I've taken Facebook sabbaticals it has actually felt good.  Being a physician also generally keeps me engaged in family medical matters (at my bequest), and with my father-in-laws illness this year, I've been very engaged.  I won't go into the other life stresses, but there are a lot more than I would have expected based on my present circumstances.  So, my mind needs rest and recovery.  I will keep blogging, however, through my taper.  And, I'll try to get back to some better blogging habits after the race.

As I'll be taking a Facebook sabbatical, starting right now (I just decided), I'll have to depend on one of my blog followers to post my blogs on FB during the next week:)  Thanks!

Thursday, September 12, 2013

Without Limits

It's remarkable that I wrote so much yesterday and forgot to conclude with something that I've thought a lot about lately during my long bike rides (some of my best thinking occurs on the bike).  There was a movie about Steve Prefontaine called "Without Limits".  Recently, Ironman World Champion Chrissie Wellington wrote a book called "A Life Without Limits".  Thinking about my blog from yesterday and my life, that truly is the mindset that I've always had.  There are no limits to what you can dream of.  A couple of years ago, after completing the hardest ironman in the history of the sport (2012 Ironman St. George), I told my wife that now I didn't need to do another ironman and I didn't need to try to get to Kona.  Kona, by the way, for those of you who don't know, is the birthplace of Ironman.  It's also the place where, in 1982, Julie Moss crawled across the finish line to come in second, mind you, after being passed within sight of the finish line (there's a message there as well, isn't there?).  To get to Kona, you have to qualify (or you can get in through a lottery).  Almost every triathlete dreams of going to Kona.

So, it didn't take long after my comment to my wife, which she didn't believe anyway, that I began thinking about doing another ironman.  That's when I signed up for Ironman Lake Tahoe.  The dreaming about Kona began somewhat later, after doing the California 70.3 (half ironman).  I finished about 30th in my age group, which is about my norm (usually right in the top 20-25% of my age group).  To qualify for Kona, you have to literally be at the top of your age group in an ironman race.  I happened to look at the times for those in the next age group, the one I was just a year away from (55-59, by the way).  My time would have placed me 7th.  Hmmm, I don't have as many people to leapfrog over to get to the top.  So, I started looking at ironman times in the 55-59 year old age group and lo and behold, I found the same thing.  I could start dreaming again!

What stood out to me about Chrissie Wellington was not that she never lost an ironman race.  It was what she did before she became a triathlete that really stuck.  She had always pursued her dreams, taking jobs that she was passionate about, trying to make a difference, even at a young age.  In her mind, there were no limits to what she could do!  To some, this might seem to be foolish, naive, idealistic, or even cocky.  To me, it was courageous.  Steve Prefontaine's story was similar.  He pushed himself to his limits and he became an Olympian (he didn't medal, but that's part of the point).

As parents, my wife and I have always encouraged our children to follow their dreams.  They have both done some remarkable things already in their lives and we couldn't be prouder of them.  We've always wanted them to be passionate about the things they do, and their talents have always shone through in those areas that they passionately embrace.  At the same time, we've never held up "success" as the carrot for their happiness and satisfaction.  With life, as in triathlon, it's all about the effort.  That's something I learned from my father, who has always given everything he does, everything he has.  He clearly instilled that in me.  The fact that he tried out for the Washington Senators in the 1950's meant far more to me than whether he made the team.  I don't know if I've ever told him that, so now I have.

A big part of my drive has always been to make a difference.  There is no where that shows through more than my life as a Geriatrician.  I want seniors to get the best possible health care.  It drives me crazy to see the way our health care system treats seniors, especially the more frail amongst them.  I used to think that getting to the top of the ladder was the only way to effect change.  I'm not so sure about that anymore.  If I were in charge of the Medicare Program itself, could I make the difference that I would want to make?  I'm not so sure about that.  I ran two health care businesses.  We did great things and did a lot of good.  The system is still broken.  So, I keep looking for ways to make the system better.  I've said that if Egypt could have a revolution via social media, perhaps we can change the way geriatric care is delivered through social media as well.  I recently saw that the position of Surgeon General is available.  No one's called me.  Could someone like me, with a passion for the care of the frail elderly that knows no bounds, make a difference in that position?  I guess I still haven't stopped dreaming...

When my father had his aneurysm repair and bypass surgery over a decade ago, I looked at myself (having had gained almost 20 pounds at the time), and realized that I needed to stay healthy through exercise.  It's what I've always preached to my patients.  Triathlon became my method of doing that.  Being a goal oriented person, it wasn't long before completing an ironman was back in the picture.  I had originally promised myself to do an ironman when I turned 40, but I was running a company and traveling and really didn't have the time (I'm still amazed at those who do this).  I wasn't about to let turning 50 go by without achieving this goal.  And hence, the inaugural Ironman St. George in 2010, became my inaugural Ironman.  But, doing one wasn't enough, so I did 2011 and 2012.  Now, Ironman Lake Tahoe beckons.  I've learned that I still have room to improve.  At the age of 54, that concept has it's limitations, but the goal of being competitive in ones age group knows no bounds.  Time isn't a limiter at that point...I can compete into my 90's, and there are many who now do.  They are my heroes.

I've wondered a bit, but I hope that my message is clear.  Don't put limits on yourself.  Don't stress over the results.  Dream...be in the moment...enjoy the journey.

Wednesday, September 11, 2013

Setting the Bar Higher and Other Tapering Musings

It's taper time, and the realization that I haven't blogged since April!  As usual (for the last forever), life has gotten in the way of writing.  We all prioritize, and my priorities this year have been family, family, family, and Ironman Lake Tahoe.  I'm actually pretty satisfied with the effort I've given to family this year.  It's not always been my greatest achievement, being a work-a-holic and all.  At the same time, I've managed to prepare myself for Lake Tahoe in a way that suggests I'm coming into this race in the best shape of my life....and at the age of 54 that's saying something!  I've been giving a lot of thought this past year to how I tend to set the bar...I think I may have blogged about this in the past, but I'm not sure when.

When I was in fourth grade, I decided to read "Martin Eden".  This is a book by Jack London that my father got as a wedding gift from his childhood friend Carl Levin (the U.S. Senator from Michigan).  It changed my father's life.  I somehow had the need to read it.  It was far above my age level at the time, but I persevered.  It's interesting looking back, in many ways it was way over my head, but that didn't bother me.

By the time I reached the seventh grade, I was bored. I wanted to start high school.  Again, the interesting thing was that I wasn't a "Straight A" student.  It wasn't like I knew everything that one could know at that point in life.  But I wanted to move on, to get to the next level.  I pushed to skip the 8th grade.  The test was for me to go to summer school at the high school and see how I did.  So, I took two high school classes in summer school and did well in both of them.  Started high school (9th grade) and was on my way.

A side note on Junior High School.  I had political leanings even back then and decided in sixth grade to run for School Treasurer.  Being a nerd (I even carried a briefcase back then), I didn't really stand a chance, but that didn't phase me.  Of course I lost.  For my encore, as I started seventh grade, I decided to run for President.  I remember giving a very serious and well thought out speech (one of the teachers actually praised the quality of my speech).  I'm sure that the kids didn't care, as they voted in one of the most popular girls in the school.

A theme is already clear.  I have always had a tendency to set bars that I can't really achieve.  I think that the act of reaching for those high bars is what I love to do.  Not scaling them isn't really an issue to me.  I rarely recall being disappointed by not achieving goals that were beyond my reach.

I had actually planned to finish high school in three years, but honestly, finally started having a good time socially and probably realized that it might have been too much.  Still, during my senior year in high school I took several classes at Cal State Long Beach.  In fact, I put my first year of college chemistry in the books, which would allow me to jump ahead when I started school at UC San Diego the following year.

No mention of athletics at this point.  Actually, I hadn't helped myself much by pushing ahead scholastically.  I was a klutz.  I had asthma.  While I loved sports, I just wasn't at the level to participate.  While I had a competitive drive, that drive wasn't at the same level as my scholastic drive at that point.  That said, I did try out for the Freshman basketball team.  It didn't go well.  I wouldn't get into organized team sports until college.

UC San Diego.  Working 15 hours a week for a scholarship.  Signing up for more classes than I could handle.  Taking Organic Chemistry as a freshman.  Sound familiar?  I also got introduced to intramural floor hockey.  Oh yes, and I fell in love.  She was the most beautiful girl I'd ever seen.  I met her the week before school started when one of my dorm mates brought her by.  My first thought was, she's too pretty to ever want to go out with me.  It took my the entire first quarter before I had the confidence to ask her on a date.  Ultimately, this was one bar that wasn't too high for me.  We've now been married for 31 years, and I still feel the same way I did that first day in the dorm every time I look at her.

My second year of college found me consumed by intramural floor hockey.  I practiced every chance I could get.  I changed my major a bunch of times.  I didn't know what I wanted to do with my life.  I was taking graduate level chemistry courses already, but I was unsettled.  I dropped out of school and immigrated to Israel.  Well, I guess I found a way to set another bar.

I ultimately got back on track a year later, went back to school at UC Irvine and finally got into medical school.  After completing my residency at Cedars-Sinai and my Geriatric Fellowship at UCLA, I became the first Geriatrician at Kaiser Woodland Hills.  Time to start setting the bar higher again.  I opened up Kaiser's first Geriatric clinic.  Having been at Kaiser for only 3 years, I won their Exceptional Contribution Award.  But it wasn't enough.  The term of the Medical Director for all of Southern California was coming up and they were looking for the next Medical Director.  I applied for the position!  I'd only been there for 3 years, but I was already setting that bar.  Looking back, it seems a bit crazy, but in the context of what I have accomplished in the last twenty years, it makes all the sense in the world.  In my work life, I always set the bar as high as possible.

What has become interesting to me as I look back is the reality of what it means to actually scale that high bar.  I became President of a company (GeriMed of America).  I co-founded and built the largest primary care Geriatric practice in the country.  I retired at the age of 53.  So what?  At the end of the day, it's not really about achieving goals, as it is living your life in a meaningful way.

Triathlon has become somewhat of a metaphor for my life in general.  It's also become an outlet for me to set the high bar.  I typically set time goals for myself before a race.  Do you want to know a secret?  I've never, ever, actually achieved one of my time goals!  It's because I always set goals that are higher than what I can achieve.  Then, so long as I give the race the full measure of my devotion, I'm happy and satisfied.

So, it's time for Ironman Lake Tahoe.  My training as gone about as well as I could expect.  I have my time goals that I've shared with no one, until now.  If you've read through this entire blog, perhaps you deserve to see my goals.  For the first time in my triathlon life, I think that I'm setting a goal that is attainable, at least on the bottom part of the range.

My typical Ironman swim has been 1:11.  At training camp I was swimming comfortably with people who swim 1:04-1:06.  While I haven't swam much in my training, I've increased my strength training, which I think will help.  Plus, Lake Tahoe is crystal clear, increasing the opportunity to draft off of other people.

My swim goal ranges from a crazy, best day ever, 1:04 to a realistic 1:10

By best ironman bike at 2011 St. George was 6:25.  This course is probably comparable, but I am biking better than I have in years.  In fact, I think that I've regained my best bike form.  I'm going to stick my neck out and set 6:00 as my crazy, best day ever, bike time.  Realistically, I'd be very happy to finish the bike in 6:15.

Ahh, the run.  My best ironman run was at the incredibly difficult 2012 Ironman St. George, where I ran about 4:32.  I've come to understand that the run is totally dependent on not swimming or biking too hard.  So, if I take the swim and bike relatively easy, a good run is possible.  I've been having my best runs ever off the bike lately, yesterday managing 6 miles @ 7:43 pace after a 2 hour bike ride.  Keeping 9 minute miles for 26 miles seems to me to be a reasonable goal.  Of course it's Ironman, once the wheels fall off, it's all over...you walk.  That said, my worst Ironman run/walk times have been 5 hours.  My crazy, best case scenario, is 3:50, while my more rational, ideal run time is 4:10.  If I could pick one goal for this race, however, it would be to complete the run in under 4 hours, regardless of what my other times are!  I don't quite know how the transition is set up in terms of running in and out of it, but I'd like to keep my transition times between 4 and 5 minutes.

The final verdict:
The High Bar (the one I never actually achieve)-11:02
The Intermediate bar (this will take the possible, but unlikely scenario that I actually achieve the reasonable goals for each discipline)-11:35

My Ironman PR is 12:45, so, anything under 12:00 would be great.  I would be thrilled to go under 11:30.

As I write this, I do realize that the time really doesn't mean too much to me.  It's a goal.  A goal is a means to and end.  The end for me, however, is the journey itself.  Being in the moment, giving the race everything I have.  That's really what it's all about.  Kind of like life itself....